Abstract

Background and Objective

Although many meta-analyses have evaluated the pharmacotherapy of intrahepatic cholestasis of pregnancy (ICP) and recommended ursodeoxycholic acid (UDCA) as an effective treatment, the defect of the pair-wise analyses and the mixture of the control group made the outcome uncertain and unclear. We aimed to employ Bayesian network meta-analysis (NMA) to compare the maternal and fetal outcomes after UDCA, S-adenosylmethionine (SAMe) mono-therapy or the combination treatment of these two drugs for ICP patients.

Methods

Multiple electronic database searches were conducted for articles published up to 1 September 2018. The relevant information was extracted from the published reports with a predefined data extraction sheet, and the risk of bias was assessed with the Cochrane risk-of-bias tool. Poisson Bayesian network meta-analysis was employed to identify the synthesized evidence from the relevant trials, with reporting hazard risks (HRs) and 95% credible intervals (CrIs).

Results

The pooled outcomes of the 13 randomized controlled trials (RCTs) with 625 participants indicated that none of the three regimens can significantly improve maternal and fetal outcomes.

Conclusion

This NMA of the RCTs clarified that the current intervention has no favorable effect on pruritus and other symptoms in ICP patients.

Compliance with Ethical Standards

Conflict of interest

The authors declare that they have no competing interests.

Funding

This study was supported in part by grants from Jiangsu Provincial Department of Science and Technology (BE2015655), China, National Natural Science Foundation of China (81370520), the Nantong Municipal Bureau of Science and Technology (HS2016002), China, and the Postgraduate Research & Practice Innovation Program of Jiangsu Province (KYCX17-1941). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

Arthur C, Mahomed K. Intrahepatic cholestasis of pregnancy: diagnosis and management; a survey of Royal Australian and New Zealand College of Obstetrics and Gynaecology fellows. Aust N Z J Obstet Gynaecol. 2014;54(3):263.CrossRefGoogle Scholar